Retinopatía vasoproliferativa secundaria a enfermedad de Waldenström / Vasoproliferative retinopathy secondary to Waldenström's disease

Paciente de 66 años en seguimiento por retinopatía diabética refractaria a múltiples modalidades de tratamiento a pesar del buen control metabólico que refiere pérdida de peso progresiva. Por este motivo se decide realizar un estudio sistémico, detectándose anemia, elevación de la velocidad de sedimentación globular e hiperproteinemia a expensas de un pico monoclonal de IgM. Posteriormente, mediante la biopsia de médula ósea y el estudio genético, se llega al diagnóstico de macroglobulinemia de Waldenström. La macroglobulinemia de Waldenström es una patología linfoproliferativa de escasa frecuencia cuya principal manifestación es a través del síndrome de hiperviscosidad. Este puede producir signos oftalmológicos detectables mediante funduscopia y pruebas de imagen. El estudio multimodal es útil en el diagnóstico y seguimiento de la afectación retiniana. La incorporación de la angiografía por tomografía de coherencia óptica permite un estudio más preciso de los trastornos microvasculares que se pueden presentar a nivel del polo posterior

A 66 year-old patient, monitored for diabetic retinopathy refractory to multiple treatment methods despite a good metabolic control, referred to progressive weight loss. For this reason, a systemic study was performed, detecting anaemia, elevation of the erythrocyte sedimentation rate, and hyperproteinaemia due to elevated serum levels of monoclonal IgM. Subsequently, by performing a bone marrow biopsy and genetic study, the diagnosis of Waldenström macroglobulinaemia was made. Waldenström's macroglobulinaemia is a low frequency lymphoproliferative disease, for which the main manifestation is a hyperviscosity syndrome that can produce ophthalmological signs detectable by funduscopy and imaging tests. A multimodal study is useful in the diagnosis and monitoring of retinal involvement. The incorporation of angiography by optical coherence tomography allows a more precise study of the microvascular disorders that may occur at the posterior pole level

Vasoproliferative retinopathy secondary to Waldenström's disease. / Retinopatía vasoproliferativa secundaria a enfermedad de Waldenström.

A 66 year-old patient, monitored for diabetic retinopathy refractory to multiple treatment methods despite a good metabolic control, referred to progressive weight loss. For this reason, a systemic study was performed, detecting anaemia, elevation of the erythrocyte sedimentation rate, and hyperproteinaemia due to elevated serum levels of monoclonal IgM. Subsequently, by performing a bone marrow biopsy and genetic study, the diagnosis of Waldenström macroglobulinaemia was made. Waldenström's macroglobulinaemia is a low frequency lymphoproliferative disease, for which the main manifestation is a hyperviscosity syndrome that can produce ophthalmological signs detectable by funduscopy and imaging tests. A multimodal study is useful in the diagnosis and monitoring of retinal involvement. The incorporation of angiography by optical coherence tomography allows a more precise study of the microvascular disorders that may occur at the posterior pole level.

Facoemulsificación versus iridotomía láser en el glaucoma primario de ángulo cerrado. Una decisión difícil / Phacoemulsification versus laser iridotomy in primary angle closure glaucoma. A difficult decision

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